Post stroke depression and risk of stroke recurrence and mortality: A systematic review and meta-analysis
Abstract
Background Post stroke depression is a significant neuropsychiatric manifestation, predicting a range of poor outcomes. There are several studies investigating the association between post stroke depression and stroke recurrence/mortality, but results have been inconsistent.Objective A systematic review, meta-analysis and meta regression of observational studies assessing the association between post stroke depression and risk of stroke recurrence and mortality.Methods A search of Medline (via PubMed), Web of Science databases, EMBASE, Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews was conducted until August 2018. We extracted and pooled hazard ratios from observational studies that reported the risk estimates of stroke recurrence and mortality in stroke survivors with/without depression.Results The reviewed sample comprised 15 prospective cohort studies with 250,294 participants, 139,276 cases, and follow-up periods ranging from 1 to 15 years. The meta-analysis concluded a hazard ratio for post stroke depression and all-cause mortality of 1.59 (95% CI, 1.30-1.96), but research to date has been insufficient to determine the association between post stroke depression and stroke recurrence.Conclusion and relevance Post stroke depression is associated with a significantly increased risk of mortality in stroke survivors. More researches are required on the association with stroke recurrence.
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In people with cardiovascular diseases and stroke survivors, MDD is associated with a significant decrease in quality of life.
“In people with cardiovascular diseases and stroke survivors, MDD is associated with increased health care costs and unplanned rehospitalizations23,25, an increased risk of atrial fibrillation and chest pain2, and a significant decrease in quality of life45,46.”
From Comorbidity between major depressive disorder and physical diseases: a comprehensive review of epidemiology, mechanisms and management (2023) · cites this paper as [45]
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- Authors
- Cai, W., Mueller, C., Li, Y.-J., Shen, W.-D., & Stewart, R.
- Affiliations
- Shanghai University of Traditional Chinese Medicine (CN)
- King's College London (GB)
- Corresponding author
- Shen, Wei-Dong
- Venue
- Ageing Research Reviews
- Publisher
- Elsevier BV
- Published
- 2019-03
- Volume
- 50
- Pages
- 102-109
- ISSN
- 1568-1637 (ISSN-L)
- OpenAlex
- W2911941199
- Cited by
- 359
- References
- 50
- Citations by year
- 2026: 32 · 2025: 60 · 2024: 63 · 2023: 75 · 2022: 48 · 2021: 49 · 2020: 21 · 2019: 10
- FWCI
- 4.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Ageing Research Reviews (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Graduate innovation training program, Shanghai University of traditional Chinese Medicine (Y201805)
- Shanghai Committee of Science and Technology, China (16401970402/18401970601)
- Three-year action plan for the development of Traditional Chinese medicine, Shanghai, China (ZYSNXD-CC-HPGC-JD-014)
- Shanghai Municipal Commission of Health and Family Planning, China (ZYKC201701001)
- National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust
- King's College London
- Topics
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- post-stroke depression, stroke recurrence, stroke mortality, stroke survivors, all-cause mortality
- MeSH terms
- Depression, Humans, Mortality, Prospective Studies, Recurrence, Retrospective Studies, Risk Factors, Stroke, Observational Studies as Topic
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